ABSTRACT
This chapter presents a case of a 44-year-old man who is admitted to an orthopaedics ward with a fracture of the femur following a car accident. He is treated surgically and there are no postoperative complications over the next 2 days. On the third day of the admission there is rapid change in his behaviour and he becomes verbally aggressive towards the nursing staff. He has been advised bed rest but tries to get up from his bed and is agitated. His eye contact is not good. He appears distracted and looks across your shoulder and around the room. He is jittery and sweating, and is confused and disorientated. He is experiencing visual hallucinations which appear to be vivid and well formed. He is terrified apparently in response to these hallucinations. He has coarse bilateral hand tremors and the extremities are cold and clammy and he is clinically dehydrated. He has palmar erythema.
